Wellstar Sylvan Grove Hospital
1050 Mcdonough Road, Jackson, GA · Wellstar Health System · · NPI 1386664779
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Mopath procedure level 8 CPT 81407 | not published | not published | $932.50 – $2,928.09 | 3 |
| Mopath procedure level 9 CPT 81408 | not published | not published | $1,068.15 – $6,920.00 | 3 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | not published | not published | $8.73 – $8.73 | 1 |
| Morphine 4 mg/ml injection (wrapper)|discarded drug not administered HCPCS J2272 | not published | not published | $7.74 – $25.71 | 2 |
| Morphine 500 mg HCPCS S0093 | not published | not published | $15.59 – $15.59 | 1 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | not published | not published | $22.01 – $22.01 | 1 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $732.42 | $1,878.00 | $220.34 – $676.50 | 4 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | $311.22 | $798.00 | $41.46 – $1,014.60 | 4 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $466.44 | $1,196.00 | $41.46 – $482.12 | 4 |
| Mosunetuzumab-axgb 1 mg/ml intravenous solution HCPCS J9350 | not published | not published | $1,221.88 – $2,178.55 | 2 |
| Motor &/ sens nrve cndj test CPT 95905 | $337.74 | $866.00 | not published | 0 |
| Mouth vestibule bx/w complex rpr 40814 CPT 40814 | not published | not published | $1,694.00 – $9,087.85 | 5 |
| M/phmtrc alys ishquant/semiq CPT 88373 | $732.42 | $1,878.00 | $46.82 – $116.84 | 3 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $732.42 | $1,878.00 | $220.34 – $781.92 | 4 |
| M/phmtrc alysishquant/semiq CPT 88369 | $610.35 | $1,565.00 | $58.43 – $170.77 | 3 |
| M/phmtrc alys skeletal musc CPT 88355 | not published | not published | $41.46 – $482.12 | 4 |
| Mpl gene analysis common variants CPT 81338 | $91.26 | $234.00 | $180.40 – $520.14 | 2 |
| M.pneumon dna dir probe CPT 87580 | $40.17 | $103.00 | $35.12 – $69.37 | 4 |
| M.pneumon dna quant CPT 87582 | not published | not published | $73.14 – $1,047.07 | 4 |
| Mpsv4 vaccine subq CPT 90733 | not published | not published | $262.93 – $262.93 | 1 |
| MRA abdomen post contrast CPT 74185 | not published | not published | $721.45 – $914.87 | 2 |
| MRA aorta thoracic w/wo contrast CPT 71555 | not published | not published | $710.02 – $904.44 | 2 |
| MRA chest w IV cont HCPCS C8909 | $1,166.49 | $2,991.00 | $574.57 – $1,085.52 | 2 |
| MRA chest wo IV cont HCPCS C8910 | $1,161.03 | $2,977.00 | $489.78 – $691.66 | 2 |
| MRA chest wwo IV cont HCPCS C8911 | $1,873.56 | $4,804.00 | $924.71 – $1,085.52 | 2 |
| MRA ext low(run-off)pst cntrst CPT 73725 | not published | not published | $715.74 – $920.49 | 2 |
| MRA pelvis CPT 72198 | not published | not published | $717.38 – $915.68 | 2 |
| MRA pelvis w IV cont HCPCS C8918 | $1,131.78 | $2,902.00 | $574.57 – $1,264.20 | 3 |
| MRA pelvis wo IV cont HCPCS C8919 | $1,221.87 | $3,133.00 | $489.78 – $691.66 | 2 |
| MRA spinal canal CPT 72159 | not published | not published | $749.24 – $933.33 | 2 |
| MRA upper extremity post contrast-bil CPT 73225 | not published | not published | $742.70 – $943.75 | 2 |
| MRA w/cont, abd HCPCS C8900 | $1,670.76 | $4,284.00 | $574.57 – $1,264.20 | 3 |
| MRA w/cont, lwr ext HCPCS C8912 | $434.46 | $1,114.00 | $924.71 – $1,085.52 | 2 |
| Mra, w/dye, spinal canal HCPCS C8931 | $439.92 | $1,128.00 | $924.71 – $1,264.20 | 3 |
| Mra, w/dye, upper extremity HCPCS C8934 | $702.00 | $1,800.00 | $574.57 – $1,085.52 | 2 |
| MRA without cont, abd HCPCS C8901 | $1,201.20 | $3,080.00 | $489.78 – $691.66 | 2 |
| MRA without cont, lwr ext HCPCS C8913 | $1,003.47 | $2,573.00 | $489.78 – $691.66 | 2 |
| Mra, without dye, spinal canal HCPCS C8932 | $439.92 | $1,128.00 | $489.78 – $691.66 | 2 |
| Mra, without dye, upper extr HCPCS C8935 | $751.14 | $1,926.00 | $489.78 – $691.66 | 2 |
| MRA without fol w/cont, abd HCPCS C8902 | $1,711.32 | $4,388.00 | $924.71 – $1,085.52 | 2 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | $1,087.71 | $2,789.00 | $924.71 – $1,085.52 | 2 |
| MRA without fol w/cont, pelvis HCPCS C8920 | $1,463.67 | $3,753.00 | $924.71 – $1,085.52 | 2 |
| Mra, w/o&w/dye, spinal canal HCPCS C8933 | $1,463.67 | $3,753.00 | $924.71 – $1,085.52 | 2 |
| Mra, w/o&w/dye, upper extr HCPCS C8936 | $1,087.71 | $2,789.00 | $924.71 – $1,085.52 | 2 |
| Mr elastography CPT 76391 | $684.06 | $1,754.00 | $415.19 – $691.66 | 2 |
| Mrgfus strtctc ablt trgt icr CPT 61715 | not published | not published | $5,809.00 – $16,710.00 | 2 |
| MRI brain w/dye CPT 70558 | not published | not published | $518.62 – $3,023.62 | 3 |
| MRI brain without dye CPT 70557 | not published | not published | $797.79 – $2,772.61 | 3 |
| MRI brain without & w/dye CPT 70559 | not published | not published | $518.62 – $3,062.87 | 3 |
| MRI breast c- unilateral CPT 77046 | $1,366.17 | $3,503.00 | $405.38 – $691.66 | 2 |
| MRI breast c-+ w/cad uni CPT 77048 | not published | not published | $667.75 – $667.75 | 1 |
| MRI breast without cont bi CPT 77047 | $1,895.01 | $4,859.00 | $402.93 – $691.66 | 2 |
| MRI breast w IV cont bi CPT 77049 | $2,034.63 | $5,217.00 | $664.48 – $664.48 | 1 |
| MRI cardiac morph & func wo IV cont CPT 75557 | $1,479.66 | $3,794.00 | $468.98 – $691.66 | 3 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | $1,604.46 | $4,114.00 | $682.25 – $1,085.52 | 3 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | $1,927.38 | $4,942.00 | $826.85 – $2,260.04 | 3 |
| MRI chest without contrast CPT 71550 | $1,810.38 | $4,642.00 | $691.66 – $960.59 | 3 |
| MRI chest without & w/contrast CPT 71552 | $2,129.40 | $5,460.00 | $1,072.78 – $1,335.06 | 3 |
| MRI chest w IV cont CPT 71551 | not published | not published | $862.80 – $2,260.04 | 3 |
| MRI fetal ea addl gestation CPT 74713 | $233.22 | $598.00 | $321.11 – $331.05 | 2 |
| MRI fetal sngl/1st gestation CPT 74712 | $132.21 | $339.00 | $691.66 – $772.44 | 3 |
| MRI guid ndl plc s&i CPT 77021 | $1,129.44 | $2,896.00 | $581.15 – $749.68 | 2 |
| MRI guid parenchymal tiss ablation CPT 77022 | $334.62 | $858.00 | $1,079.78 – $1,079.78 | 1 |
| MRI loex nonjt w IV cont CPT 73719 | $1,739.40 | $4,460.00 | $744.34 – $1,085.52 | 3 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $1,716.39 | $4,401.00 | $683.06 – $841.09 | 3 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $2,090.40 | $5,360.00 | $907.73 – $1,135.39 | 3 |
| MRI orbit fac&nck w IV cont CPT 70542 | $2,132.13 | $5,467.00 | $593.18 – $1,085.52 | 3 |
| MRI tmj CPT 70336 | $1,276.08 | $3,272.00 | $540.13 – $696.77 | 4 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $1,741.74 | $4,466.00 | $683.87 – $847.53 | 3 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $2,115.36 | $5,424.00 | $902.02 – $1,125.77 | 3 |
| MRI upper extremity w/dye CPT 73219 | $1,905.15 | $4,885.00 | $736.98 – $1,085.52 | 3 |
| MRI w/cont, breast, bi HCPCS C8906 | $1,967.55 | $5,045.00 | $924.71 – $1,085.52 | 2 |
| MRI w/cont, breast, uni HCPCS C8903 | $1,423.11 | $3,649.00 | $518.62 – $574.57 | 2 |
| MRI without fol w/cont, breast HCPCS C8908 | $2,034.63 | $5,217.00 | $924.71 – $1,085.52 | 2 |
| MRI without fol w/cont, brst, un HCPCS C8905 | $1,508.13 | $3,867.00 | $924.71 – $1,085.52 | 2 |
| Mr spectroscopy CPT 76390 | $1,539.72 | $3,948.00 | $256.49 – $934.93 | 4 |
| Msh2 gene dup/delete variant CPT 81297 | not published | not published | $182.05 – $738.02 | 4 |
| Msh2 gene full seq CPT 81295 | not published | not published | $182.05 – $1,320.68 | 4 |
| Msh2 gene known variants CPT 81296 | not published | not published | $155.44 – $1,168.55 | 4 |
| Msh6 gene dup/delete variant CPT 81300 | not published | not published | $194.02 – $823.48 | 4 |
| Msh6 gene full seq CPT 81298 | not published | not published | $345.40 – $2,220.80 | 4 |
| Msh6 gene known variants CPT 81299 | not published | not published | $193.49 – $1,065.68 | 4 |
| Mt bone graft microvasc CPT 20957 | not published | not published | $6,389.00 – $15,026.00 | 2 |
| Mthfr gene analy common variants CPT 81291 | $296.79 | $761.00 | $71.46 – $226.08 | 4 |
| M.tuberculo dna dir probe CPT 87555 | not published | not published | $35.12 – $93.00 | 4 |
| M.tuberculo dna quant CPT 87557 | not published | not published | $75.05 – $148.23 | 4 |
| Mucin synovial fluid CPT 83872 | $65.52 | $168.00 | $10.27 – $20.28 | 4 |
| Mucopolysaccharides CPT 83864 | $299.13 | $767.00 | $34.88 – $98.61 | 4 |
| Mucormycosis antibody CPT 86732 | not published | not published | $23.10 – $51.90 | 4 |
| Multi family grp psychotherapy CPT 90849 | not published | not published | $450.03 – $450.03 | 1 |
| Multifocal erg w/i&r CPT 92274 | not published | not published | $440.91 – $440.91 | 1 |
| Multiple sleep latency test CPT 95805 | $1,531.14 | $3,926.00 | not published | 0 |
| Mumps antibody igg CPT 86735 | $106.86 | $274.00 | $22.87 – $45.15 | 4 |
| Muscle-skin graft arm CPT 15736 | not published | not published | $1,937.00 – $5,809.00 | 5 |
| Muscle-skin graft leg CPT 15738 | not published | not published | $1,937.00 – $10,126.62 | 5 |
| Muscle-skin graft trunk CPT 15734 | not published | not published | $1,937.00 – $10,126.62 | 5 |
| Muscle test cran nerv unilat CPT 95867 | $377.52 | $968.00 | $885.97 – $885.97 | 1 |
| Muscle test hemidiaphragm CPT 95866 | $121.68 | $312.00 | $440.91 – $440.91 | 1 |
| Muscle test larynx CPT 95865 | $317.07 | $813.00 | $360.57 – $360.57 | 1 |
| Muscle test one fiber CPT 95872 | $273.00 | $700.00 | $440.91 – $440.91 | 1 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.